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picture1_Contractor Invoice Template Excel 40108 | Engineering Invoice


 187x       Filetype XLSX       File size 0.04 MB       Source: dlnreng.hawaii.gov


File: Contractor Invoice Template Excel 40108 | Engineering Invoice
sheet 1 invoice state of hawaii department of land and natural resources engineering division payment no 1 progress invoice for the work performed from 010121 to 063021 date 070521 contractor ...

icon picture XLSX Filetype Excel XLSX | Posted on 14 Aug 2022 | 3 years ago
Partial file snippet.
Sheet 1: Invoice
STATE OF HAWAII

DEPARTMENT OF LAND AND NATURAL RESOURCES

ENGINEERING DIVISION








Payment No. 1

PROGRESS INVOICE

FOR THE WORK PERFORMED FROM 01/01/21 TO 06/30/21











Date 07/05/21














CONTRACTOR AE Consultant CONTRACT NO. 60000














ADDRESS 100 One Street JOB NO. J00XX00A















Honolulu, Hawaii 96813 PO/FINAL/No Retainage No














PROJECT TITLE Test Reservoir Project














CONTRACT WORK ACCOMPLISHED














Original Contract Amount


$50,000.00 Completed to Date
9% $ 4,299.75














SUPPLEMENTAL CONTRACTS & CHANGE ORDERS Retained
5.0% $ 214.99
$1,250.00





(5% max up to 50% of Contract Amount)


5.0%
Total Additions $-













Amount Subject to Payment




Total Deductions $-
$ 4,084.76






Previous Payments to Date




Adjusted Contract Amount
$- $ Amount Subject to Payment from previous invoice 10.00



















Payment Now Due

$ 4,074.76

Contract Amount as Amended


$50,000.00

































Remarks: none














none














none




















I certify that the above bill is correct and just and that payment thereof has not been received.




















AE Consultant







Name of Contractor






Signed By:





















John Doe, President

For DLNR use only:




(Typed Name and Title)

GOODS/SERVICES REC'D IN SATISFACTORY CONDITION
For DLNR use only:






Signature Date:
This is to certify that this is an electronically transmitted invoice that has not been previously paid and will not be presented for payment again.


Initial Date


Invoice Rec'd


Approved:




OK to Pay


DLNR: DLNR PM/DM to approve & sign
/



Circle PARTIAL FINAL
Signature
Date


Sheet 2: Recap Sheet


FOR THE PERIOD OF: 01/01/21

DEPARTMENT OF LAND AND NATURAL RESOURCES TO 06/30/21


RECAP SHEET TO ACCOMPANY PAYMENT NO.:




1

Project: Test Reservoir Project





ITEM DESCRIPTION CONTRACT AMOUNT COMPLETED TO DATE

% AMOUNT

1 Coordination $17,199.00 25% $4,299.75

2 Lidar Mapping (ATA) $5,883.00 0% $-

3 Lidar Drone Vendor Fee $9,668.00 0% $-

4 Boundary Survey $17,250.00 0% $-

5 Final Submittal $- 100% $-

6
$- 0% $-

7
$-
$-

8


$-

9


$-

10


$-

11


$-

12


$-

13


$-

14


$-

15


$-

16


$-

17


$-

18


$-

19


$-

20 Supplemental Contract 1

$-
DLNR: sum of supplements, additional changes, etc. will carry over to invoice 0.00
21 Landscape Redesign $- 0% $-

22 Work due to flood $-
$-

23 Supplemental Contract 2

$-
DLNR: sum of supplements, additional changes, etc. will carry over to invoice 0.00
24 Item 4 taken out of contract $- 100% $-

25 Item 3 Part taken out of contract $- 100% $-

26


$-

27


$-

28


$-

29


$-

30


$-


TOTALS $50,000.00 9% $4,299.75









The words contained in this file might help you see if this file matches what you are looking for:

...Sheet invoice state of hawaii department land and natural resources engineering division payment no progress for the work performed from to date contractor ae consultant contract address one street job jxxa honolulu pofinalno retainage project title test reservoir accomplished original amount completed supplemental contracts amp change orders retained max up total additions subject deductions previous payments adjusted now due as amended remarks none i certify that above bill is correct just thereof has not been received name signed by john doe president dlnr use only typed goodsservices rec d in satisfactory condition signature this an electronically transmitted previously paid will be presented again initial approved ok pay pmdm approve sign circle partial final recap period accompany item description coordination lidar mapping ata drone vendor fee boundary survey submittal sum supplements additional changes etc carry over landscape redesign flood taken out part totals...

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